0000731012-24-000090.txt : 20240529 0000731012-24-000090.hdr.sgml : 20240529 20240529172029 ACCESSION NUMBER: 0000731012-24-000090 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240528 FILED AS OF DATE: 20240529 DATE AS OF CHANGE: 20240529 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FROME ROBERT L CENTRAL INDEX KEY: 0000946426 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-12015 FILM NUMBER: 24999706 MAIL ADDRESS: STREET 1: 3220 TILLMAN DRIVE SUITE 300 CITY: BENSALEM STATE: PA ZIP: 19020 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HEALTHCARE SERVICES GROUP INC CENTRAL INDEX KEY: 0000731012 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 232018365 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3220 TILLMAN DRIVE STREET 2: SUITE 300 CITY: BENSALEM STATE: PA ZIP: 19020 BUSINESS PHONE: 2159381661 MAIL ADDRESS: STREET 1: 3220 TILLMAN DRIVE STREET 2: SUITE 300 CITY: BENSALEM STATE: PA ZIP: 19020 4 1 wk-form4_1717017621.xml FORM 4 X0508 4 2024-05-28 0 0000731012 HEALTHCARE SERVICES GROUP INC HCSG 0000946426 FROME ROBERT L 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 1 0 0 0 0 Common Stock 2024-05-28 4 A 0 3728 10.73 A 26140 D Represents a grant of unvested deferred stock units ("DSU") which will become fully vested on the one year anniversary of the grant date. Such DSUs will be settled in shares of common stock on the first to occur of (i) five-year anniversary of the Date of Grant, (ii) the Participant's date of death, disability or separation from service; or (iii) the date of a Change of Control (the "Settlement Date"). A Participant may elect a further deferral beyond the Settlement Date pursuant to the rules of Code Section 409A. Amount represents 6,563 unvested DSUs, 4,669 vested DSUs, and 14,908 shares of common stock. /s/ Michael Harrity, by Power of Attorney 2024-05-29